A comparative study to evaluate the safety and efficacy of low-dose isotretinoin monotherapy versus a combination of low-dose isotretinoin and superficial chemical peels in patients with moderate-to-severe acne vulgaris

Abstract

Objectives: The aim of the study was to compare the safety and efficacy of low-dose isotretinoin (LDI) monotherapy versus a combination of LDI and superficial chemical peels in treating moderate-to-severe acne in patients attending tertiary care hospital. Material and Methods: Sixty patients in the age group of 15–45 years having moderate-to-severe acne vulgaris were enrolled in the study. The patients were randomly divided into two groups of 30 patients each by random table number method. Group A – patients were put on LDI (0.25 mg/kg body weight [wt]) for 3 months. Group B – LDI (0.25 mg/kg body weight) was started, and these patients were subjected to six sessions of sequential superficial chemical peels every fortnightly for 3 months. Results: Treatment outcome was measured in terms of improvement in global acne grading (GAG) score, pigmentation, scarring, and seborrhea. The mean GAG score at week 0 in Group A was 29.2 ± 5.03, and Group B was 26.7 ± 5.11. The mean GAG score at week 12 in Group A was 15.9 ± 5.09, and in Group B was 9.23 ± 3.24, which showed statistically significant improvement (P < 0.001) in both groups. Post-inflammatory hyperpigmentation and erythema also improved significantly. There was no significant improvement in scarring, yet Group B showed a better response. The patient satisfaction score was high in Group B. Seborrhea improved equally in both groups. Conclusion: LDI gives a good balance between efficacy- and dose-related side effects. Both groups showed statistically significant results in terms of acne severity (global acne grading system (GAGS) W-0 26–29–W12 15– 9). Group B showed faster improvement than Group A.